Healthcare Provider Details

I. General information

NPI: 1609428010
Provider Name (Legal Business Name): LEAH KRISTEN ADAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2019
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 AIRPORT BLVD STE B
PENSACOLA FL
32504-8622
US

IV. Provider business mailing address

1100 AIRPORT BLVD STE B
PENSACOLA FL
32504-8622
US

V. Phone/Fax

Practice location:
  • Phone: 850-281-1679
  • Fax:
Mailing address:
  • Phone: 251-599-9252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-53267
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: